The Division of Insurance regulates all aspects of the insurance business in the
Commonwealth including licensing of agents, brokers, and companies, examination of
domestic and foreign insurance companies, and oversight of sales, marketing and claim
practices. Consumers may address questions about all aspects of insurance to this office
between 8:45 a.m. and 5:00 p.m. Consumer complaints must be made in person at the office
during those hours or submitted in writing.

This office was created by Chapter 141 of the Acts of 2000, in conjunction with the Department of Public Health’s
Office of Patient Protection (see D14 below), to oversee and enforce compliance of health insurance carriers,
insures, and HMOs operating in the state. Contact this office to file a complaint by phone, e-mail, or fax.

The Office of Patient Protection, created by Chapter 141 of the Acts of 2000
and in operation since January 1, 2001, is charged with developing regulations and
implementing new statutory provisions of M.G.L. Chapter 1760 for residents
covered by a state carrier, insurer or HMO regarding their rights to
understanding their health coverage’s internal grievance procedures, as well
as establishing a process for obtaining an independent external review where
coverage is denied based upon a medical necessity determination. An insured
individual who receives an adverse determination of an internal grievance has
the right to an external review of a covered benefit within 45 days, and may
obtain the necessary forms by calling this office or by accessing the
department’s website for a form. To file a complaint, contact the Division of
Insurance’s new Bureau of Managed Care (see D13 above).

The Insurance Fraud Bureau is a private entity licensed by the state under MGL Ch. 175A:8, was
mandated by MGL Ch.266:111B (Ch. 338 of the Acts of 1990). Its purpose is to prevent and
investigate fraudulent insurance transactions by insured individuals against their
insurance company. These illegal transactions can be criminally prosecuted.

Accident surcharges may be appealed to the Board of Appeals within 30 days of
receipt of the Merit Rating Surcharge Notice. Convictions of moving violations
are considered surchargeable incidents and are not appealable to the board. Any
action of the Registry of Motor Vehicles and automobile insurance cancellations
may also be appealed to this board.

The Commonwealth Health Insurance Connector Authority created by Chapter 58 of the Acts of 2006 and signed into law
on April 12th, 2006 requires citizens on Massachusetts to have health insurance. Based upon income eligibility, those at or
below 300% of the federal poverty level may enroll in a Commonwealth Care plan. Beginning in 2014, as a result of national
health reform, all Massachusetts residents under 133 percent of the federal poverty level (FPL) will be eligible for MassHealth
if they are citizens or qualified aliens. For example, a family of four that makes less than $31,000 a year may qualify for
MassHealth. New federal tax credits designed to help people pay for their health insurance premiums will also become available.
Prior to passage of the ACA, individuals and families in Massachusetts earning up to 300% FPL (about $35,000 for an individual
and $70,000 for a family of four) could get help paying for their health insurance premiums. Starting in 2014, people with incomes
up to 400% of the federal poverty level (about $45,000 for an individual and $94,000 for a family of four) may qualify for federal
tax credits to lower the cost of their premiums when they purchase insurance plans through the Health Connector.
State-Subsidized Health Plans:
In addition to federal tax credits, Massachusetts offers additional savings to those who are eligible (those earning up to 300% FPL).
ConnectorCare plans are a set of health insurance plans with lower premiums and lower out-of-pocket costs that are subsidized
by the state, as well as by the federal government through national health reform. By shopping through the Health Connector,
individuals can easily and quickly find out if they qualify for one of these plans.